Evolving therapies in esophageal carcinoma:
Gespeichert in:
Format: | Buch |
---|---|
Sprache: | English |
Veröffentlicht: |
Philadelphia, Pa.
Elsevier
2013
|
Schriftenreihe: | Thoracic surgery clinics
23,4 |
Schlagworte: | |
Online-Zugang: | Inhaltsverzeichnis |
Beschreibung: | X S., S. 454 - 581 Ill., graph. Darst. |
ISBN: | 9780323242370 |
Internformat
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245 | 1 | 0 | |a Evolving therapies in esophageal carcinoma |c ed.: Wayne L. Hofstetter |
264 | 1 | |a Philadelphia, Pa. |b Elsevier |c 2013 | |
300 | |a X S., S. 454 - 581 |b Ill., graph. Darst. | ||
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Datensatz im Suchindex
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---|---|
adam_text | Evolving Therapies in Esophageal Carcinoma
Contents
Preface: Evolving Therapies in Esophageal Carcinoma
ix
Wayne L.
Hof
stette
r
Radiographie
and
Endosonographic
Staging in Esophageal Cancer
453
Mark J.
Krasna
Radiographie
imaging using computed tomographic (CT) scan and positron
emission tomography/CT are primarily helpful in identifying distant
métastases.
In general, if patients have evidence of lymph node involvement that is proved
pathologically by
endoscopie
ultrasound/fine needle aspiration, this information
is considered
definitive,
and the patient can be referred for the appropriate
stage-specific therapy. Laparoscopy combined with
laparoscopie
ultrasound
and peritoneal
lavage
has been shown to have sensitivity of
67%
and specificity
of
92%
for lymph node disease. Thoracoscopy may help identify involved
lymph node in the mediastinum before resection and help determine the field of
radiation.
Esophageal Cancer Staging: Past, Present, and Future
461
Thomas W. Rice and Eugene H. Blackstone
TNM cancer staging, conceived
70
years ago, was first applied to the esophagus in
1977.
Prior staging was neither data-driven nor harmonized with stomach cancer.
Machine-learning analysis of worldwide data addressed these shortcomings in the
7th edition. The 8th edition considers
6
problems in attempting to advance esoph¬
ageal cancer staging.
Personalizing Therapy for Esophageal Cancer Patients
471
Toshitaka Hoppo and Blair
A. Jobe
Management of esophageal
cancar
starts with accurate tissue diagnosis and
clinteai
staging. Advances in screening and
ѕигушИапс»
programs and
endoscopie
tech¬
niques have resulted in patients with early-stage esophageai cancer diagnosed
more frequently.
Endoscopie mucosa!
resection for staging
te
essential to diagnose
T1 a cancer and crucial to exclude risk factors for progression to cancer or presence
of concomitant cancer. Esophagectomy is an essential component of treatment of
locally advanced, resectabte esophageai cancer. Despite intensive
muftìdisciplirrary
approaches, the prognosis of esophageal cancer is unacceptable. This article
focuses on the process of decision making used to select optimal therapy for esoph¬
ageai cancer.
Endoscopie
Management of Barretfs Esophagus with High-Grade Dysplasia and
Early-Stage Esophageai Adenocartinoma
479
Marta L
Davila
and Wayne
L Hofstetter
Several
endoscopie
procedures have been recently developed for the treatment of
Barrett s esophagus and early esophageai cancer, including
endoscopie
resection,
radiofrequency ablation, and
cryoabłation.
Hits review article discusses ideal
vi
Contents
candidates for
endoscopie
therapies, current treatment modalities, clinical and
safety outcomes, and specific management recommendations.
Surgery for Esophageal Cancer: Goals of Resection and Optimizing Outcomes
491
Nabil Rizk
Determining what defines an adequate esophageal resection to optimize long-term
outcomes in esophageal cancer is an elusive goal. The primary reason for this
ambiguousness is the almost total lack of good quality prospective randomized sur¬
gical trials that examine this question adequately. Most available data are derived
from small retrospective series typically representing single institution series and
their treatment biases. The intent of this article is to identify the goals of an appro¬
priate esophagectomy for cancer, essentially defining the targets that should be
achieved from an operation.
Induction Therapy for Esophageal Cancer
499
Subroto Paul
and Nasser Altorki
Despite advances in treatment, long-term outcomes for esophageal cancer remain
poor, with overall survival rates of between
15%
and
35%.
Poor long-term survival
reflects locoregionally advanced disease or metastatic disease at presentation.
Among patients undergoing surgical resection,
40%
to
50%
have stage III disease.
Surgery alone results in poor locoregional control and poor long-term outcomes,
with survival rates ranging from
10%
to
30%.
Induction therapy combining surgery
with chemotherapy with or without radiotherapy attempts to improve long-term
survival in these patients. This article examines the merits of various modalities of
induction therapy for patients with locally advanced esophageal cancer.
Neoadjuvant Chemotherapy or Chemoradiotherapy for Locally Advanced Esophageal
Cancer
509
B. Mark
Smithers
and lain Thomson
In patients with operable esophageal cancer, there is evidence supporting the use
of
preoperative
chemotherapy or
preoperative chemoradiation.
The addition of
radiotherapy to chemotherapy seems more relevant for the more locally advanced
cancers. There is a need to examine in trials more modern chemotherapy combina¬
tions with and without concurrent radiation and for research into assessing methods
for predicting outcomes from neoadjuvant therapy as part of the paradigm of
therapy for this disease.
Adjuvant (Postoperative) Therapy for Esophageal Cancer
525
Geoffrey Y. Ku and David H.
Hson
This article focuses on adjuvant (postoperative) strategies for locally advanced
esophageal cancers. Results of completed phase III trials of postoperative therapy
for locally advanced adenocarcinomas and squamous cell carcinomas (SCCs) of
the esophagus and gastroesophageal (GE) junction are summarized. Several post¬
operative and
perioperative
strategies have been shown to improve survival by
approximately
15%
when compared with surgery alone for adenocarcinomas of
the esophagus and GE junction. On the other hand, all proven strategies for resect-
able SCCs involve
preoperative
treatment, and there are no validated strategies for
the postoperative treatment of SCC.
Contents
vii
Update
on Clinical Impact, Documentation, and Management of Complications
Associated with Esophagectomy
535
Donald E. Low and
Artur
Bodnár
The assessment and monitoring of complications associated with esophageal
resection suffers from the absence of an internationally recognized system for doc¬
umenting the incidence and severity of complications. The impact of complications
is significant, with direct effects being identified on mortality, length of stay, postop¬
erative quality of life, and long-term survival. Newer systems of assessing surgical
complication severity and the resources required to treat complications include
the Accordion and Clavien grading systems. New
endoscopie
and interventional
approaches to treating anastomotic leak and stricture and chyle leak can selectively
decrease length of stay and costs of managing complications.
Chemoradiation for Esophageal Cancer
551
Mariela A. Blum, Takashi Taketa, Kazuki
Sudo,
Roopma Wadhwa, Heath D. Skinner, and
Jaf
f
er
A. Aja
η
і
Esophageal
cancer management
is based on baseline clinical stage, location of the
tumor, and associated comorbid conditions. In patients with localized esophageal
cancer
(LEC)
with technically resectable tumors and who are medically fit for surgery,
the current recommendation is trimodality therapy (chemoradiation followed by sur¬
gery). Bimodality therapy (definitive chemoradiation) is reserved for patients with cer¬
vical esophageal tumors, technically unresectable tumors, for patients who cannot be
recommended surgery due to medical comorbidities, or those who decline surgery.
Prospective data from
2
studies suggest that definitive chemoradiation may be suf¬
ficient for
LEC
with squamous cell histology; a definite answer, however, is unclear.
Salvage Esophagectomy in the Management of Recurrent or Persistent Esophageal
Carcinoma
559
Jenifer Marks, David C. Rice, and Stephen G. Swisher
{ЈИ
Video of salvage esophagectomy with omental transfer accompanies this article
Salvage esophagectomy is a viable treatment option in the management of recurrent
or persistent esophageal cancer and can be performed with acceptable morbidity
and mortality in a select group of patients. Patient selection should include a com¬
plete restaging evaluation, cardiopulmonary testing, and an assessment of func¬
tional status. A majority of patients with persistent or recurrent esophageal cancer
are not candidates for salvage resection. Carefully selected patients undergoing
a salvage resection can have outcomes similar to those undergoing a planned
esophagectomy after definitive chemoradiotherapy.
Quality of Life in Patients with Esophageal Cancer
569
Gail E. Darling
Evaluation of health related quality of life (HRQOL) is an important outcome measure
for patients with esophageal cancer. The patient s perception of HRQOL is the
outcome of interest rather than that of the health care professional, family or care-
giver. HRQOL is not simply a list of symptoms, as patients may report good HRQOL
despite experiencing symptoms of their disease or its treatment. HRQOL is similar
after surgery alone or chemoradiation followed by surgery although recovery is
more rapid after minimally invasive or transhiatal esophagectomy.
Longterm
survi¬
vors report HRQOL similar to the normal population for long term survivors.
Index
577
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spelling | Evolving therapies in esophageal carcinoma ed.: Wayne L. Hofstetter Philadelphia, Pa. Elsevier 2013 X S., S. 454 - 581 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Thoracic surgery clinics 23,4 Clinics review articles Speiseröhrenkrebs (DE-588)4132808-5 gnd rswk-swf Therapie (DE-588)4059798-2 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Speiseröhrenkrebs (DE-588)4132808-5 s Therapie (DE-588)4059798-2 s DE-604 Hofstetter, Wayne L. Sonstige (DE-588)1046157353 oth Thoracic surgery clinics 23,4 (DE-604)BV019335438 23,4 Digitalisierung UB Regensburg - ADAM Catalogue Enrichment application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=026994461&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
spellingShingle | Evolving therapies in esophageal carcinoma Thoracic surgery clinics Speiseröhrenkrebs (DE-588)4132808-5 gnd Therapie (DE-588)4059798-2 gnd |
subject_GND | (DE-588)4132808-5 (DE-588)4059798-2 (DE-588)4143413-4 |
title | Evolving therapies in esophageal carcinoma |
title_auth | Evolving therapies in esophageal carcinoma |
title_exact_search | Evolving therapies in esophageal carcinoma |
title_full | Evolving therapies in esophageal carcinoma ed.: Wayne L. Hofstetter |
title_fullStr | Evolving therapies in esophageal carcinoma ed.: Wayne L. Hofstetter |
title_full_unstemmed | Evolving therapies in esophageal carcinoma ed.: Wayne L. Hofstetter |
title_short | Evolving therapies in esophageal carcinoma |
title_sort | evolving therapies in esophageal carcinoma |
topic | Speiseröhrenkrebs (DE-588)4132808-5 gnd Therapie (DE-588)4059798-2 gnd |
topic_facet | Speiseröhrenkrebs Therapie Aufsatzsammlung |
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